Initial success of Affordable Care Act could rely on how many young Americans enroll

WASHINGTON (WUSA 9) -- They are the least health insured of all Americans. They are young Americans -- 18 to 34-year-olds.

"There's a lot of reasons to that - a lot of them are beginning their careers, they have part time jobs, might not have access to employer coverage," said Brian Burrell, the Midwest Regional Manager of Young Invincibles, a group created to educate young adults about the Affordable Care Act.

He said there is often a misconception about uninsured young people.

"That's how a lot of people think young adults are - that they're young and invincible and that's why people choose not to have health insurance - the number one reason actually is cost. The fact that there are new, affordable options is going to help a majority of them," said Burrell.

Whether that will be enough to entice them to enroll remains to be seen. A poll released this month by Harvard's Institute of Politics showed that only 29 percent of uninsured 18 to 29-year-olds plan to buy coverage via Healthcare.gov or a state-run exchange.

"If we don't get those young, healthy people in the system, that could cause problems for everybody else buying insurance," said Robert Zirkelbach with America's Health Insurance Plans, the national trade association representing the health insurance industry.

The ACA needs youth to sign up, pay and balance out the costs of older Americans who generally need more health care and, therefore, cost more to insure.

"Some of them will have access to care for the first time in their lives," said Burrell. "So, being able to check and make sure that they're not going to have any long-term health issues that have gone undiagnosed so far, can help save, not only young adults, but the health care system a lot of money."

What might bode well for the ACA and help get youth in the door is that people 26-year-olds and younger can remain on their parent's health coverage as well as the fact that many unemployed youth will now have access to subsidies and Medicaid.

A problem point that might deter them is a fear that they could pay more for premiums than now. Starting in 2014, the ACA will limit how much insurers can charge older Americans. To make up for that, some suggest insurers will likely pass those costs on to youth.

Those who remain without a health plan that qualifies as minimum essential coverage may have to pay a fee that begins at one-percent of income and increases every year.

Burrell stressed that in order for youth to accept and buy in, they will need to think about health care differently, that the new law will need to usher in a new mindset.

"It's a change in culture. In the past it has not always been assumed that you will have access to care. So, it's kind of a shift in, not just our generation, but in the entire population in that, now everybody who wants it has access to it," said Burrell. "So, getting over that culture shift is going to take a while."